Search results for "Obstetric"
showing 10 items of 2144 documents
Laparoscopic Management of External Iliac Artery Injury Using Yasargil Clamps and Intracorporeal Suture
2011
Presented is a case report of laparoscopic repair of an external iliac artery injury using titanium Yasargil clamps and intracorporeal suture during lymphadenectomy. Yasargil clamps were introduced and placed, 1 distal and 1 proximal to the lesion. The vascular injury site was identified and repaired using intracorporeal sutures. Laparoscopic staging was completed successfully. No sign of thrombosis or vascular occlusion was detected. The patient was discharged on postoperative day 4 to receive adjuvant therapy. Laparotomy is the accepted way of managing major vascular injuries during laparoscopy. However, in controlled circumstances, with availability of Yasargil clamps and a surgeon exper…
Definition of a dynamic laparoscopic model for the prediction of incomplete cytoreduction in advanced epithelial ovarian cancer: Proof of a concept
2015
Abstract Objective To develop an updated laparoscopy-based model to predict incomplete cytoreduction (RT>0) in advanced epithelial ovarian cancer (AEOC), after the introduction of upper abdominal surgery (UAS). Patients and methods The presence of omental cake, peritoneal extensive carcinomatosis, diaphragmatic confluent carcinomatosis, bowel infiltration, stomach and/or spleen and/or lesser omentum infiltration, and superficial liver metastases was evaluated by staging laparoscopy (S-LPS) in a consecutive series of 234 women with newly diagnosed AEOC, receiving laparotomic PDS after S-LPS. Parameters showing a specificity≥75%, PPV≥50%, and NPV≥50% received 1 point score, with an additional…
Minilaparoscopic aortic lymphadenectomy.
2015
Abstract Study Objective To show the feasibility of performing aortic lymphadenectomy with 3-mm instruments in gynecologic malignancies. Patient A 43-year-old, multiparous patient with serous ovarian cancer grading 2, Federation Internationale de Gynecologie et d'Obstetrique stage IC (intraoperative spillage). Intervention The patient was accidentally diagnosed with ovarian cancer after a right adnexectomy performed for an ovarian cyst. Once referred to our center, a delayed surgical staging was planned including total hysterectomy, left adnexectomy, aortic and pelvic lymphadenectomy, peritoneal biopsies, and total omentectomy. Minilaparoscopy was believed to be feasible to achieve it. Meas…
How Technology Can Impact Surgeon Performance: A Randomized Trial Comparing 3-Dimensional versus 2-Dimensional Laparoscopy in Gynecology Oncology
2016
This randomized clinical trial (Canadian Task Force classification I) aimed to compare 2-dimension (2-D) versus 3-dimensional (3-D) laparoscopic hysterectomy and pelvic lymphadenectomy in endometrial and cervical cancer patients. Between December 2014 and March 2015, 90 patients were enrolled: 29 (32.2%) with early or locally advanced cervical cancer after neoadjuvant treatment and 61 (67.8%) with early-stage endometrial cancer. Patients were randomly assigned to undergo 2-D (Group A, n = 48 [53.3%]) or 3-D (Group B, n = 42 [46.7%)]) laparoscopy. Baseline characteristics were superimposable in the 2 groups. Median operative time was similar in the 2 groups. Median estimated blood loss durin…
Associations of maternal circulating 25-hydroxyvitamin D3 concentration with pregnancy and birth outcomes
2015
Objective To investigate the association of maternal circulating 25-hydroxyvitamin D3 [25(OH)D3] concentration with pregnancy and birth outcomes. Design Prospective cohort study. Setting Four geographical areas of Spain, 2003–2008. Population Of 2382 mother–child pairs participating in the INfancia y Medio Ambiente (INMA) Project. Methods Maternal circulating 25(OH)D3 concentration was measured in pregnancy (mean [SD] 13.5 [2.2] weeks of gestation). We tested associations of maternal 25(OH)D3 concentration with pregnancy and birth outcomes. Main outcome measures Gestational diabetes mellitus (GDM), preterm delivery, caesarean section, fetal growth restriction (FGR) and small-for-gestational…
Peritoneal sarcomatosis 5 years after laparoscopic morcellation of uterine leiomyoma.
2017
In 2011, a 40-year-old woman underwent laparoscopic myomectomy with intraabdominal morcellation. Histology report showed leiomyoma without atypia, necrosis, or mitosis. In 2016, she complained of left lower quadrant pain; ultrasound examination revealed a left hypogastric mass in the site of trocar placement. Percutaneous biopsy results showed a low-grade endometrial stromal sarcoma (LGESS). At laparoscopy, we observed: multiple nodules on uterine serosa, left annex, vesical peritoneum (Figure 1), Douglas pouch (Supplementary Video1), previous left pelvic trocar site (Figure 2), greater omentum (Figure 3), and right/left diaphragm.
Laparoscopic Sentinel Lymph Node Detection After Hysteroscopic Injection of Technetium-99 in Patients With Endometrial Cancer
2015
Background and Objectives Endometrial cancer (EC) has an increasing incidence worldwide. Despite the unequivocal prognostic importance of nodal status, systematic lymphadenectomy is associated to elevated morbidity. Sentinel lymph node (SLN) biopsy is designed to avoid extensive nodal dissection and provide crucial oncologic information. The goal of this prospective study was to determine the feasibility, safety, and accuracy of laparoscopic SLN biopsy in EC obtained through hysteroscopic injection of technetium-99 (Tc-99). Methods From January 2008 to December 2012, a total of 42 women with EC were included in the study. We injected 20 mBq of Tc-99 hysteroscopically underneath the tumor mi…
Hysteroscopic removal of a gauze inadvertently retained in uterus for two years following caesarean section
2021
Despite the worldwide accomplishment of manual counting procedures of surgical textiles and instruments, cases of retained (forgotten) surgical items (RSIs) still occur. Gauzes are the most frequently RSIs, accounting for 90% of the cases because they are widely used. Approximately half of the cases occur in the context of general surgery procedures, fol- lowed by gynaecological – obstetrics surgery. The time inter- val between initial surgery, diagnosis and removal of the gauze is clinically relevant, as the morbidity and mortality are reduced if the foreign body is removed immediately after the offending operation. We report on a successful hysteroscopic identification and removal of a ga…
A high oocyte yield for intracytoplasmic sperm injection treatment is associated with an increased chromosome error rate.
2009
Objective To compare the chromosome error rate among oocytes from stimulated ovaries after retrieval of 1–5 oocytes, 6–10 oocytes, and >10 oocytes. Design Retrospective cohort study. Setting A university-based human genetic institute in collaboration with a private fertility center. Patient(s) Nine hundred thirty-three women undergoing intracytoplasmic sperm injection (ICSI) with a poor prognosis. Intervention(s) Oocyte collection with ovarian stimulation. Polar body testing of ICSI oocytes for common chromosome errors. Main Outcome Measure(s) Chromosome error rate in oocytes, as determined by five-color fluorescence in situ hybridization. Result(s) In women less than 35 years and women bet…
Therapeutic group psychoeducation and relaxation in treating fear of childbirth
2006
The increase in the numbers of women fearing childbirth and requesting cesarean sections call for new forms of antenatal treatment.Finnish nulliparous women experiencing severe fear of childbirth (experimental group, n = 102) attended 5 group sessions with a psychologist, once together with a midwife, during the third trimester. One session was held 3 months after the delivery. Each session consisted of a discussion of fear and feelings towards the impending birth and parenthood in a psychotherapeutic atmosphere and of relaxation exercises focused on an imaginary childbirth. The results were compared with those of 85 women treated for fear of childbirth by 2 appointments with an obstetricia…